Claims Supervisor

Benecard Services Inc. • Clifton, NJ

1d • $70,000 - $80,000 • Onsite

About The Position

National Vision Administrators is seeking an experienced Claims Supervisor to oversee daily operations of the vision eye care claims team. This role ensures accurate and timely Medicaid and Medicare claims adjudication, while maintaining compliance with regulatory requirements and company standards.

Requirements

• 5+ years of Medicaid/Medicare claims processing and adjudication experience
• Strong knowledge of CPT, ICD-10, HCPCS, modifiers
• Strong knowledge of CMS-1500 (HCFA 1500) forms and electronic billing
• Strong knowledge of Timely filing, resubmissions, appeals, and remittance advice
• Experience with COB/TPL and denied claims resolution
• Familiarity with AS400 or similar claims systems
• Strong Excel and Microsoft Office skills
• Excellent communication and organizational skills

Nice To Haves

• CPC, CPB, or CBC certification is preferred
• Prior experience in vision plans, optometry, ophthalmology, or eye care billing is preferred

Responsibilities

• Supervise claims staff and manage daily workflow
• Review and process complex and high-dollar claims
• Ensure accuracy of medical billing and coding (CPT, ICD-10, HCPCS, modifiers)
• Manage COB/TPL claims and resolve denials/rejections
• Ensure Prompt Pay compliance and regulatory adherence
• Oversee ManageEngine tickets and escalations
• Support audits, reporting, and quality assurance initiatives
• Train and develop team members

Benefits

• Vacation and Sick/Personal Time
• Medical Insurance / Prescription / Vision / Dental
• Hearing Program Discount
• Short- & Long-Term Disability Insurance
• Life Insurance
• Flexible Spending Account
• 401(k) plus company match
• Employee Referral Program
• Employee Recognition
• Tuition Reimbursement
• Professional Development Training

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed